PARTIAL MASTECTOMY WITHOUT RADIATION IS ADEQUATE TREATMENT FOR PATIENTS WITH STAGE-0 AND STAGE-I CARCINOMA OF THE BREAST

The treatment of potentially curable carcinoma of the breast has chang ed from one operation, radical mastectomy, to a flexible approach. At the Cleveland Clinic, we use four types of treatment for primary poten tially curable carcinoma of the breast (Stages 0, I and II)-modified r adical mastectomy, simple mastectomy, partial mastectomy with postoper ative adjuvant radiation therapy and partial mastectomy without radiat ion therapy. The latter treatment (partial mastectomy without adjuvant radiation) is controversial. We recommend this procedure for patients with T(is) and T1 carcinomas that appear to be localized, without lym ph node metastases, Stages 0 and I disease. The overall and disease-fr ee survival rates are similar to those of patients having modified rad ical or partial mastectomy with radiation. Local recurrence is slightl y higher at five years (11.0 percent) as compared with the other proce dures, but at ten years, is only 16.1 percent, a figure comparable wit h patients having partial mastectomy with radiation (14.4 percent). Fo r patients with Stages 0 and I carcinoma of the breast, the addition o f postoperative radiation therapy after partial mastectomy seems to be unnecessary.